Where have all the statistics gone?

"Hitting the glass ceiling" is a phrase frequently used by career oriented women who feel frustrated when their efforts to have corporate board room doors opened to them are thwarted. "Hitting the glass ceiling" is beginning to be the cry of many of us as we are systematically thwarted by those responsible for collecting, analysing and releasing the annual statistics for abortions performed in Canadian hospitals and clinics. Abortion statistics are becoming a closely guarded secret.

In 1969 the abortion law was liberalized to allow therapeutic abortions in cases where "the continuation of the pregnancy...would likely endanger the life or health of the mother" (health was not defined). Statistics Canada was given the responsibility of compiling accurate and (anonymous) data in terms of the demographics and medical details for the the provinces: the age and marital status of the mother, the gestational age of the child, the method of abortion, the number of previous pregnancies, the number of previous miscarriages, the number of previous abortions, concurrent sterilization, and any complications (haemorrhage, perforation of the uterus etc.) arising from the immediate surgery. This data would provide a complete profile of the pregnancy termination. Initially this was done very efficiently; however, in 1978 when Quebec began to report the numbers for clinic abortions there were no medical details supplied.

Dr. Ivan Fellegi became Chief Statistician of Canada in 1985 and in 1986 it was he who recommended to the Minister responsible for statistics, Stewart McInnes, that they cease compiling abortion statistics because "they did not give a precise and worthwhile picture of therapeutic abortions done in Canada". David Bray, Director of Health Services, issued an August 1986 directive to the hospital administrators requesting that they discontinue sending the annual Therapeutic Abortion form to Statistics Canada as a "cost cutting measure" and that "the figures weren't relevant to most Canadians". This, despite the fact, that the number of abortions reported in 1986 had escalated to 69,572 from the 11,000 reported in 1971.

There was such a public outcry from various groups interested in the impact of abortion on Canadian society that the new Minister Responsible for Statistics, the Honourable Monique Vézina, reversed the decision. She promised the House of Commons that: "The method of compiling the (abortion) figures will be changed to provide a more precise picture of the therapeutic abortions performed in Canada". Chief Statistician of Canada, Ivan Fellegi was advised to continue the annual collection of abortion statistics.

Each year the number of abortions and repeat abortions continues to rise. The number of reported abortions performed in provincial clinics has also risen to represent one third of all abortions. Not only has the quality of the hospital data continued to deteriorate but, as well, the details about therapeutic clinic abortions are not provided, despite the promise of a more "precise" picture. The time period between the release of current statisitics is lengthening: for example, the 1994 stats were released in September 1996 and the 1995 figures were released in November 1997 (a record number of 106, 658 abortions). As of February 1999 we still await the data for 1996!

Understandably, Action Life was alarmed by the trend toward less and less information about a medical procedure which will affect 34% of Canadian women in their lifetime (1 in 3) if the 1993 first abortion rate prevails (Family Planning Perspectives: Jan/Feb 1997, Vol. 29, No. 1). Even the (late) abortion activist, Dr. Marion Powell noted that according to Statistics Canada, the most frequently performed surgery in Canada is induced abortion. She was concerned that "because of the lack of consistency in the reporting of abortion statistics, the actual number of abortions performed in the clinics can only be estimated" (Can. Med. Assoc. J 1st. June, 1997; 156 (11)).

There was a new development when it was announced that the Canadian Institute for Health Information (CIHI) had been created and would take over the role of the Hospital Medical Records Institute which had compiled the figures for hospital procedures and channeled them to Statistics Canada for analysis and publication from 1970 to 1993. CIHI was described as a non governmental organization with the mandate to "provide a comprehensive and integrated system of health information". CIHI's Executive Committee Members would represent " both government and non-government partners" and Dr. Fellegi would serve as Vice-Chairperson of the Board of Directors. CIHI would collect the statistics for the 1995 abortions.

Our efforts to meet with both the Minister of Health and the Minister for Statistics began. In July 1996 we wrote to request a meeting with the then Minister of Health, the Hon. David Dingwall to no avail. Not until two years later, after repeated requests, did we achieve a meeting with the Senior Policy Adviser to the Hon. Allan Rock, Mr. John Dossiter (July 1998). Dr. Joel Brind Ph.D. accompanied us. After outlining our concerns about the need for women to be informed about the negative psychological and physical effects of abortion (including post abortion trauma, depression, infertility, sterility etc.), Dr. Brind effectively defended the accuracy of the 1996 meta analysis of 23 international studies which demonstrate the direct link between induced abortion and breast cancer. A woman who aborts her first pregnancy increases her risk for developing breast cancer by 50% independent of any other recognized risk factors. This causal link alone validates the need for accurate medical histories and detailed statistical data. Mr. Dossiter promised that this exchange of opinions would be brought to Mr. Rock's attention.

Beginning in July 1996 we tried to meet with John Manley, Minister Responsible for Statistics. We followed the recommendation from his office that we meet with the Director of CIHI, Carol Acorn and with representatives from the office of Janet Hagey, Director of Health Statistics Division, Statistics Canada. They did agree that abortion was elective surgery, warranting the compilation of complete medical information but felt it might be an invasion of privacy. We suggested that medical histories are routinely taken before any surgery. Since Dr.Fellegi could stop the compilation of statistics surely he had the clout to request compliance? They suggested that the best avenue to take was to meet with both the Minister of Statistics and the Minister of Health.

In September 1996 Mr Manley responded to say that we should continue our discussions with Janet Hagey of Statistics Canada. We then met at the Action Life office with Ms. Hagey and the Chief of Health Care Statistics, Cyril Nair. They reassured us that CIHI would do a better job of gathering data and asked that we await the publication of the 1995 statistics to judge their quality. These were published in November 1997 with less data than ever before!

Once again we were advised to meet with Mr. Manley to whom Dr. Fellegi is accountable. In our letter of April 1998 we wrote Mr. Manley outlining all the steps followed and once again requested a personal meeting. To our surprise as his reply in June 1998 we received a letter from Dr. Fellegi basically saying that everything was fine! In June 1998 we wrote again requesting a personal meeting with Mr. John Manley and after numerous telephone calls were promised a meeting before Christmas 1998 with an assistant. As of February 1999 this promise has not been honoured.

The matter is urgent. British Columbia is no longer providing medical details for the hospital abortions and Ontario, which accounts for 43% of all abortions, is dragging its feet in producing the abortion figures. The specific medical details for clinic abortions are unknown or sparse. Nancy Miller Chenier (Political and Social Affairs Division, Research Branch of the Library of Parliament) described her attempt to calculate the cost of abortion to taxpayers as a "complex and inexact process". Using the conservative figure of 100,000 abortions for the fiscal period 1992-93, Ms. Chenier estimated the cost for same day hospital and clinic abortions to be a very "relevant" $51,646,926.00!

Each day the Statistics Canada Daily prints current statistics on their web site for such matters as the crop yield reports for various grains, the number of light bulbs produced, the number of asphalt shingles produced annually, the number of toilet seats manufactured etc. Under the Statistics Canada Act, Mr. Manley has the authority to request compliance for the complete abortion figures, the demographics and the medical details for therapeutic abortions performed in Canadian hospitals and clinics.

The former Health Minister, Monique Bégin, said in the Globe in Mail, August 26, 1996 in reference to personal responsibility for the tainted blood scandal, "blame me". She said, "The notion of 'ministerial responsibility' is the cornerstone of our executive government". By assuming this responsibility, Mr. Manley can "break the glass ceiling" so that the public may have full access to this vital information about abortion and its effect on the health of Canadian women.